57例新型冠状病毒肺炎治愈患者胸部电子计算机断层扫描特征报告

目的 探讨胸部电子计算机断层扫描（computed tomography，CT）在新型冠状病毒肺炎（COVID-19）中的诊疗价值。方法 对长沙市第一医院57例已治愈的新型冠状病毒肺炎患者进行胸部CT总结分析，并与患者临床表现、实验室检查及治疗方案结合，旨在为临床诊疗提供依据。结果 57例患者入院时有55例已出现肺部病变，以胸膜下、肺底为主的磨玻璃影、实变影为特点。入院时有症状者51例，大多症状轻微，与肺部病变严重程度不平行，表现为肺部病变重而临床症状轻。入院后3~5 d症状改善32例，症状加重9例，其中肺部病变明显进展者仅有4例存在临床症状加重，病变进展后均调整治疗方案，3~5 d后复查胸部CT，肺部病变均较前好转。结论 胸部CT对新型冠状病毒肺炎的筛查及诊断具有重要价值，但需警惕轻型病例的存在，并需与其他病毒、支原体、衣原体等病原体感染相鉴别，与病毒核酸检测结合可更好地避免误诊及漏诊。在治疗过程中，定期监测胸部CT，可更好地了解病情变化，及早调整治疗方案。同时胸部CT是出院标准的重要条件之一。

Chest computed tomography characteristics report of 57 patients with COVID-19

Objective To evaluate the value of chest computed tomography (CT) in the diagnosis and treatment of COVID-19. Methods A summary analysis was performed on the chest CT of 57 cases of newly cured coronavirus infection in Changsha First Hospital and combined with clinical manifestations, laboratory tests and treatment regimen was conducted to provide evidence for clinical diagnosis and treatment. Results Fifty-five of the 57 patients were admitted to hospital with pulmonary lesions which were characterized by ground glass shadow and consolidation shadow mainly under the pleura and lung base. Totally 51 cases were showing symptoms when admitted to hospital, most of which had mild symptoms and were not in parallel with the severity of pulmonary lesions, showing severe pulmonary lesions and mild clinical symptoms. After 3-5 days of admission, symptoms were improved in 32 cases, while worsened in 9 cases, of which only 4 cases had symptoms of aggravation. The treatment plan was adjusted with progress of the lesions. After 3-5 days, the chest CT examination showed that the pulmonary lesions were alleviated. Conclusion The chest CT is of great value in the screening and diagnosis of pneumonia infected by novel coronavirus. It should be noted that it may be insensitive to identification of mild cases. It should be differentiated from other pathogens such as other viruses, mycoplasma, and chlamydia, etc. Misdiagnosis and missed diagnosis could be avoided with assistance of viral nuclei acid detection. During the treatment process, regular chest CT monitoring can be helpful to ascertain the patient's progresses and adjust the treatment plan as soon as possible. Meanwhile, the chest CT is one of the important discharge requirement.